Medication errors are now the leading cause of accidental death. Smart electronic devices are emerging to aid medication adherence with organizing, reminding, monitoring, and communicating medication use. Most are focused on bulk pills and are structured to dispense pills, remind at pill-time, monitor when pills are taken, or communicate pill histories to caregivers. As pharmaceutical packaging and delivery forms have evolved in recent years, bulk pills are losing dominance among medication forms. For example, in Europe, they represent only 10-15% of oral medication sales, with 85-90% packed in single- unit doses in blister packs or multi-pill dosing packets. Moreover, injections are gaining market share and are expected to outsell oral meds, as biotech introduces many biologics that are injected. They now account for one fifth of new drugs launched on the world market, and soon that share is expected to rise to one-half that are biotechnology-derived. These biologics can be unstable, require refrigeration, and sometimes are time-critical in their dosing schedules. None of these trend-setting drugs fit into traditional medminding models. Five major medication user groups are underserved with the present models. Yet, their patterns of nonadherence are equally as concerning and the risks to their safety are just as alarming. It is these five major drug forms that this project addresses: " Blister packed pills. " Injectables in both prefilled and syringe/vial forms " Refrigerated medications " Time-critical medications with immediate reports to caregivers. " Liquid and topical medication dispensers and over-sized pills. We propose a novel, multi-purpose dispenser that performs critical functions to improve medication adherence. The product will fill a large gap in the market now for medication users of the five targeted forms, whose care teams need instant awareness of their risk, and for whom there are no other assistive devices that serve these needs. This project will leverage our team's decade of experience and existing portfolio of products and intellectual property in developing and commercializing a pioneering electronic medminder. PUBLIC HEALTH RELEVANCE: A critical public health concern is mismanagement of medications, which all-too-often exacerbates diseases and multiplies comorbidities. It is part of NIH's mission to promote innovation in combating diseases. We propose a novel, multi-purpose dispenser that serves to improve medication adherence for emerging medication forms, packaging, and delivery systems for which there is no technological aid currently.